Reverse Total Shoulder Arthroplasty — (rTSA)

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling in neutral rotation with abduction pillow (30-45 deg) wks 0-3; wean sling Phase II (4-6 wks); discontinue sling Phase III (7-8 wks)

Key Restrictions

No shoulder AROM or AAROM Phase I; no PROM into IR Phase I; no reaching behind back (especially IR) x 12 wks; no lifting >coffee cup through Phase III; no supporting body weight with hands; avoid shoulder hyperextension; pillow under elbow in supine to avoid hyperextension; PROM IR initiated gradually in scapular plane at 7-8 wks (≤50 deg); no push to end ranges

Timeline & Phases

6 phases: Phase I (0-2 wks, PROM only), Phase II (4-6 wks, AAROM/AROM initiated), Phase III (7-8 wks, progress all planes, discontinue sling), Phase IV (9-10 wks, light resistance), Phase V (11-14 wks, progressive strengthening), Phase VI (15+ wks, return to function)

Notes

Criterion-based; deltoid and periscapular muscle emphasis throughout; scapular plane elevation primary motion; ER PROM to tolerance Phase I (≤120 deg flex, ≤90 deg ABD); posterior deltoid activation: avoid shoulder extension when isolating; specific complications to monitor: fever, numbness/tingling, excessive drainage, tenderness over acromion. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-01-03.]

Surgeon / Author

MGH Sports Medicine